Clinical breast cancer
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Clinical breast cancer · Feb 2003
Bone pain associated with once-per-cycle pegfilgrastim is similar to daily filgrastim in patients with breast cancer.
Bone pain is a common side effect of treatment with filgrastim. Pegfilgrastim is a pegylated long-acting analogue of filgrastim that is administered once per chemotherapy cycle. The profile of prospectively defined, patient-reported bone pain judged by the investigators as related to study drug was analyzed retrospectively for each drug using data from two comparable phase III trials. ⋯ Among patients with bone pain, a trend towards earlier onset with pegfilgrastim was observed but was not associated with increased bone pain severity or duration. In patients who received a fixed 6-mg dose of pegfilgrastim, the overall bone pain incidence was similar when analyzed by body weight (< 60 kg, 60-100 kg, > 100 kg). No patients were withdrawn from either study for bone pain.
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Clinical breast cancer · Dec 2002
Comparative Study Clinical TrialWeekly docetaxel/paclitaxel in pretreated metastatic breast cancer.
The purpose of our study was to evaluate the feasibility and efficacy of weekly docetaxel/paclitaxel in pretreated advanced breast cancer patients. Twenty-six patients with metastatic breast cancer were included in this study. Three different schedules of treatment were administered. ⋯ Treatment was well tolerated; myelosuppression was rare and grade 3 cutaneous toxicity was observed in only 2 patients. In conclusion, weekly docetaxel/paclitaxel is active at low dosages and was well tolerated as salvage chemotherapy in metastatic breast cancer. This regimen represents a valid option as a salvage treatment in taxane- and anthracycline-pretreated patients.
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Clinical breast cancer · Dec 2002
Multicenter Study Comparative Study Clinical TrialPhase II trial of doxorubicin/docetaxel/cyclophosphamide for locally advanced and metastatic breast cancer: results from NSABP trial BP-58.
Based on the recommended phase II doses for doxorubicin (60 mg/m2) and docetaxel (60 mg/m2) and the National Surgical Adjuvant Breast and Bowel Project's (NSABP) experience with doxorubicin and cyclophosphamide (cyclophosphamide 600 mg/m2), we conducted a phase II trial at 18 institutions using doxorubicin/docetaxel/cyclophosphamide (ATC) given every 21 days, in preparation for a major adjuvant breast cancer study (NSABP B-30), in which ATC would be used. Eligibility requirements included measurable stage IIIB/IV breast cancer, performance status 0-2, normal left ventricular ejection fraction, and no prior chemotherapy for metastatic disease (nontaxane adjuvant chemotherapy was allowed if completed > 12 months before entry and if the cumulative dose of doxorubicin was =240 mg/m2). Eighty-nine patients were entered who ranged in age from 30-78 years (38.2% < 50 years; 61.8% =50 years). ⋯ The median survival time was 35.6 months (95% CI, 26.6-39.4 months). The administration of ATC with primary ciprofloxacin and secondary colony-stimulating factor prophylaxis is feasible and active. Its value in the adjuvant setting is currently under investigation.
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Clinical breast cancer · Dec 2002
ReviewAdjuvant use of taxanes for patients with breast cancer: we see the tip of the iceberg.
Advances in screening techniques for breast cancer have led to the diagnosis of more patients at earlier disease stages at which time the possibility of a cure is more likely. Adjuvant chemotherapy with anthracycline-based regimens has proven to reduce the risk of relapse and cancer-related death in women with early-stage breast cancer. Recent studies have aimed at integrating the taxanes, paclitaxel and docetaxel, into the adjuvant setting, but to date, we are still in the earliest stages of the study of patients with operable breast cancer. ⋯ Many of the trials began in the late 1990s and are not yet mature. For node-positive patients, the available evidence supports the use of taxanes as adjuvant treatment since they are safe and appear to provide benefit. Going forward, docetaxel holds significant promise in the adjuvant setting, and further trials as well as further follow-up of existing trials are eagerly awaited to help us determine whether docetaxel is best given sequentially to, or concurrently with, doxorubicin or epirubicin.
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Clinical breast cancer · Oct 2002
ReviewOngoing US cooperative group trials using taxanes in the adjuvant setting.
The use of systemic adjuvant therapy in women with early-stage breast cancer has been demonstrated to have a profound impact on survival. The role of paclitaxel and docetaxel in the adjuvant setting has attracted a great deal of attention. Both of these agents are highly active in patients with advanced breast cancer. ⋯ The Breast Cancer International Research Group trial 001 compared the combination of docetaxel/doxorubicin/cyclophosphamide to 5-fluorouracil/doxorubicin/cyclophosphamide. This trial demonstrated a promising reduction in the relative risk of recurrence of 32% for the docetaxel/doxorubicin/cyclophosphamide group. Ongoing trials will help to further define the role of taxanes in the adjuvant setting for patients with operable breast cancer.